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General NPI Number Information
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NPI Number | 1548305808
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Entity Type | Organization
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Legal Business Name | BERTHA ABES CHILDREN'S CENTER,INC.
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1662 LINCOLN CT APT 501
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City | MIAMI BEACH
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State | FL
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Zip | 33139-2125
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Country | US
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Telephone | 305-674-4494
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Fax |
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Provider Business Mailing Address
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Address Line | 5801 BISCAYNE BLVD
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City | MIAMI
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State | FL
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Zip | 33137-2638
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Country | US
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Telephone | 305-756-7116
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Fax |
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Authorized Official
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Title or Position | CLINICAL SUPERVISOR
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Name | DR. LINDA MARTINEZ
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Credential | PSY.D.,
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Telephone | 305-756-7116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH5195
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License Number State | FL
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